ED Accreditation Update

IOM report recommends Joint Commission action

The Institute of Medicine's (IOM's) three-year "Future of Emergency Care" project, recently completed, includes recommendations for the Joint Commission on Accreditation of Healthcare Organizations.

Specifically, the report titled Hospital-Based Emergency Care: At the Breaking Point, recommends that the Joint Commission should put into place strong standards about ED crowding, boarding, and diversion. In particular, the practices of boarding and ambulance diversion should be eliminated except in the most extreme circumstances, such as a community mass-casualty event.

In a prepared statement, the Joint Commission said it supports this call to build an emergency care system that can adequately serve ED patients. "Our nation's health care system currently provides only a patchwork of emergency care," said Dennis S. O'Leary, MD, president of the Joint Commission. "Fixing hospital-based emergency care, including overburdened emergency departments, ultimately means fixing much of what ails our health system."

The Joint Commission is ready to work with stakeholders to address the issues surrounding hospital-based emergency care, the statement says. The agency has taken a number of significant steps, including the 2005 standard on managing patient flow, according to the statement.

"This standard places the accountability for managing patient flow with hospital leaders, who must provide the resources — both financial and human — to manage this critical patient safety issue," O'Leary said. "But public policy-makers must eventually come to grips with the broader issues that are adversely affecting emergency care capacity in this country."

Additionally, the Joint Commission supports the development of national performance measures to evaluate the effectiveness, efficiency, and quality of emergency services, the agency said.